Calcium (Regular, hypo, & hypercalcemia) Flashcards
what is the range of calcium
8.5 - 10.5
Ca is best friends with which electrolyte
Mg
when Ca goes up, Mg goes
up
when Mg is low calcium does what for Mg
it helps Mg with the function
Ca keeps the 3 B’s what
strong
what are the 3 B’s
Bone - 90% of the body’s calcium
Blood clotting
Beat (hr) myocardial contraction
where does 90% of the body’s Ca go
the bones
what 3 hormones regulate Ca
parathyroid
calcitonin
calcitrol
the parathyroid hormone is made and released by what gland
parathyroid gland
when Ca+ levels are low what hormone elevates them
PTH
calcitonin is regulated by what gland
thyroid gland
when Ca+ levels are high, what is released to lower Ca+ and put it back in the bones
calcitonin
calcitrol controls blood calcium by suppressing the release of what
PTH
what is the normal range of ionized calcium
4.8-5.6
What is ionized calcium
calcium in blood not attached to proteins (free calcium)
what is the most accurate test for assessing true calcium status
an ionized calcium test
why is ionized calcium important
important of there are abnormal levels of protein
what signs of these diseases would ionized calcium be drawn (3)
if there are signs of kidney
liver
parathyroid
what causes hypocalcemia (7)
vitamin D deficiency
long-term corticosteroids usage
hypoparathyroidism
renal disease
massive diarrhea
hyperphosphatemia
meds
what is required for absorption of Ca
Vitamin D
what can cause hypoparathyroidism (2)
decrease in parathyroid hormone
removal of parathyroid glands
why does hyperphosphatemia cause hypocalcemia
because phospate is in an inverse relationship with calcium
what meds can cause hypocalcemia (3)
diuretics
laxitives
corticosteroids (contribute to bone loss)
what surgeries can cause possible hypocalcemia due to irritating/possibly removing the parathyroid glands (2)
thyroidectomy
any neck surgeries
how will the cardiovascular system appear in a pt who has hypocalcemia (3)
hypotension
dysrhythmias (V Tach)
decreased hr
how will the neuromuscular system appear in a pt with hypocalcemia (5)
irritable skeletal muscles - twitching, cramps, tetany, seizures, paresthesias
painful muscle spasms in calf/foot
positive Trousseau’s & Chvostek’s signs
hyperactive DTRs
osteoporosis - body trying to get more calcium
how will the GI system appear in a pt who has hypocalcemia (2)
hyperactive bowel sounds
diarrhea
what is a positive sign of Chvostek’s look like
when taping the masseter on the face, the muscles will contract/twitch
what is a positive Trousseau’s sign
get a bp cuff and inflate higher than pt’s normal systolic
hold for 3 mins
pos sign: hands draw in as thumb, wrist, & MCP joints flex, fingers stay extended
what are the interventions for hypocalcemia
replace calcium (IV or PO)
Initiate seizure & bleeding precautions
Move pt carefully
Educate on calcium-rich food
what IV fluid can we give to replace calcium
calcium gluconate 10%
how long should we give calcium gluconate
over 10-20 mins
what PO meds should we give to replace calcium (2)
Vitamin D tab
Aluminum hydroxide (Tums) calcium supplements
what causes hypercalcemia (4)
hyperpararthyroidism
Antacids
Malignancies
Renal disease - inability to excrete
how do antacids cause hypercalcemia
there is an excess intake of calcium & vitamin D
what malignancies cause hypercalemia (2)
bone malignancies
bone destruction
what is released into the bloodstream with bone malignancies
calcium
how will a pt’s neuromuscular appear when they have hypercalcemia (2)
muscle weakness
diminished or absent DTRs
what type of bowel sounds will we hear in a pt who has hypercalcemia
hypoactive bowel sounds
what do hypoactive bowel sounds in hypercalcemia indicate
constipation
what will form in the kidneys when a pt has hypercalcemia
kidney stones
what interventions do we do for hypercalcemia (6)
Admin IV fluids
Discontinue calcium
Loop diuretics
Meds
Dialysis if meds fail
Educate on avoiding calcium rich foods
what IV fluid is admined to pt with hypercalcemia
0.9% NS
why is NS the fluid used for a pt with hypercalcemia
to help them excrete the calcium
what meds need to be discontinued in a pt with hypercalcemia
oral meds w/ calcium & vitamin D
what loop diuretic would be admined to a pt with hypercalcemia
furosemide (lasix)
what meds would be given to a pt with hyper calcemia (3)
phosphorus (inverse relationship w/ Ca)
calcitonin
bisphophonates
What do IV NS & loop diuretics indicate about a pt with hypercalcemia
less severe form of hypercalcemia
